How Advances in Wearable Technology Impact Digital Health: An Interview With John Nosta

John Nosta is a leading voice in the convergence of technology and health and an influential thinker entrenched in the world of science, medicine and innovation. He is the founder of NostaLab, an organization dedicated to the advancement of digital health.

We spoke with John Nosta to dissect how advances in technology like sensors and fitness trackers impact the world of digital health.

1. Tell us about your work at NostaLab – what are you most excited about and what is your strategy for empowering innovation in healthcare?

My background is Chief Strategic Officer and Agency President at Ogilvy, which is the largest healthcare communications company in the world. What I found is that both agencies and life science companies were disconnected from the phenomenon we call digital health. They didn’t understand the nuances of quantified self and the applications of digital technology to help in medicine.

Most client and agency people understood Fitbit and Nike Fuel as a fitness device that lived largely in the context of digital wellness. And thats part of the continuum that we are looking at now. Digital wellness has to move into digital health and digital medicine, because there are so many different applications of technology in this area.

So my feelings in starting NostaLab were to create a communications company that walked the walk in the context of digital health. I am an active participant in the marketing, the science, and all the thought leadership development in this area so that I can work with clients to give them a real world understanding of the changes, evolution, opportunities and pitfalls of digital health.

NostaLab is the power of innovation through a sense of communication that we don’t only participate in, but we live. That is our mission.

2. How do you see advances in wearables and sensor technology influencing the health care ecosystem?

I believe it is no longer about the device, but about the data. The devices will evolve to become less of a watch that you wear, and perhaps a dermal or a patch or an implant -- or will ultimately completely go away to be absorbed into the fabric of our lives.

I think this is the fundamental change in sensor technology. We will see sensors in the steering wheel of our car. And those sensors will become extraordinarily simple and will not be a function of us charging them or wearing them. They will exist passively in the context of our lives. This goes beyond the quantified self and enters into the quantified life.

In the future, your bathroom will become a living laboratory, and the bathroom will be sponsored by a company like Johnson & Johnson or some other company that makes bathroom fixtures. It will have a rich array of laboratory analyses that will quantify you and your family. For example the mirror will have a reflective image that looks at pulse or at skin issues. The toothbrush will be able to monitor bacterial growth in your mouth to measure for cavities.

The other room is the kitchen. Every time you open the refrigerator door it will quantify what comes in and out. Your shopping lists will be generated by a computer and sent to your smartphone. So you will never have to worry about being out of milk because it will be quantified. Similarly, that quantification can also be expressed in the context of calories and total metabolic consumption.

The point is that it won’t be you actively tracking this stuff, data will be passively tracked in the context of your daily life. Digital health will actually become nothing, just like the sensors in our car. We have no awareness of these sensors that track our brake speed or air pressure of the tires, unless something goes wrong. Here lies the fundamental reality of digital health from a consumer perspective.

From a technical, scientific and medical perspective, digital health offers extraordinary advantages that are practical applications of tools and technologies.

Ten years from now we will wonder how reckless it was to let a human drive a car. It’s that kind of pivotal change that I call exponential change, which is a drastic change in the fundamental way we see life.

3. What new technology are you most excited about in terms of its influence on digital health?

Eric Topol, one of the big leaders in the digital health movement, is actually looking at nano and micro sensors that can be used in the body to track certain chemicals that will tell you that you are having a heart attack.

Let’s take a step back and think about this -- from a patient’s perspective and a physician’s perspective, a heart attack is considered to be a major event that gets everyone nervous. We see a heart attack today as an event that requires urgent and rapid engagement. But what we understand is that a heart attack is actually a gradual process in the body, and if it can be detected early enough with nano sensors, the right procedures can be put in place to improve care. This is part of the magic of digital health and sensor technology.

Another one is Kinsa, a digital thermometer that sends data to your smartphone to create a real record of temperature readings that you can track over time, look at graphically and share with your doctor. But the amazing thing Kinsa does that gives it such potential is that it takes this depersonalized data and pushes it to the cloud. So now we can look at a weather map of fever.

Think about that in the context of a region of the US. Imagine it in a local school district where parents can look at a relative heat map of who is sick or what area is getting sick. Pushing this to the cloud is another way of taking a sensor and using that data in a way that informs people about the relevant prevalence of something like the flu.

4. What are the roadblocks fitness trackers and sensor technology will have to overcome to make a difference in healthcare?

The interesting thing about tech is that we don’t know what is going to happen. The changes are occurring so quickly in fundamental areas of science, that to try to link these profound innovations to the mundane accelerometer that defines the wearable today is a fools errand.

We are seeing exponential changes in the rate in which innovations come to life. We are seeing the rate of change happen so quickly, similar to Moore’s Law. So it’s almost a matter of wearables and devices having to keep pace with advancing technologies.

If you ask a physician about digital health, you will probably get a funny look or a shrug of the shoulders unless that physician is wearing a device or has a unique interest in the digital health movement. We have to inform and motivate the gatekeepers about things like Kinsa, the world’s smartest thermometer.

Oftentimes we see that physicians just don’t have this stuff on their radar. And when confronted by this democratized patient who is demanding digital health, it leads to more of an impact.

5. So what do you think is the future of the fitness device?

The quantified self movement is not going to go away. We’ve started off with a fundamental issue of connectivity.

Right now, if you look at the fitness devices, they seem to appeal to people who don’t need them. The girl who wants to go to the gym to see how fast she works out or the guy who wants to see a map of his run. They are not being used by the guy who is on the couch. Many healthcare providers aren’t using them either. There’s a disconnect. The promise of it is still robust and will be revolutionary. But the simple premise of “if we build it they will come” will not work. We need to fill in the gap.

We can’t expect people to use technology that is not compatible with their fundamental lifestyle. Not only on a functional, tactical level but also a psychological level. We need to develop wearables that fit in with peoples’ behavior and style and give people an amazing incentive to use them.